International Medical Aid (IMA)

My experience with International Medical Aid was outstanding. I learned so much about my personal interests in medicine and my role as a global citizen. I am incredibly grateful for the opportunity I had to visit Mombasa, Kenya, and meet such inspiring, genuine people. Thank you to the IMA staff for your constant support and guidance. You went above and beyond to welcome us and ease the transition to Kenya. The residence was beautiful and safe. I felt comfortable and reassured by the security and the organization by all management. The food was great! I greatly appreciate the kitchen staff and all of their hard work. Thank you for introducing us to Kenyan food and always greeting us with warmth and kindness. The community in Kenya was so welcoming and happy. I absolutely loved getting to know individuals at the hospital, clinics, and locals from the Mombasa area. Viviane and Aaron guided us on the safari and they were the best. I was so grateful for the pure joy and excitement they brought on the trip. Bella, Margaret, and Benson, thank you for all of your support and constant attention to detail to make sure each and every one of us had an enjoyable stay. Hilda, Naomi, and all of the housing staff, thank you for making the residence feel like home. I always felt comfortable and happy. Your friendship and kindness made a huge impact on me over the three weeks of my stay. Dr. Shazim, thank you for inspiring us to be active learners and challenge ourselves as medical students, but more importantly, as human beings. Your passion for medicine and education was refreshing. You made us all excited to learn and share about our time in the hospital. This trip was such a touching and inspiring experience. I had the opportunity to put myself in uncomfortable or foreign situations, inside and outside of the hospital, pushing myself to handle each situation with grace and gratitude. I learned so much about the socioeconomic challenges that impact the Mombasa community and healthcare system. I also learned so much about medicine from the inspiring healthcare professionals at Coast General, and I am so grateful for the time I had to grow and expand my medical knowledge. The environment and culture in Kenya warmed my heart. Everyone is kind and eager to learn and love one another. I felt this welcoming energy and will carry it with me in my future medical plans. Asante Sana. Moments after observing a cesarean section for the first time, I turned the corner to the maternity ward and heard a woman screaming. I rushed to her bedside, hoping I might witness a vaginal birth, but the air in the maternity ward was thick and tense. A young woman named Brenda had been in labor for nearly 24 hours. Exhausted and agonized, she rolled in her bed and attempted to find a comfortable position. As I stood beside her, silently watching her struggle, I felt an overwhelming sense of helplessness. My medical knowledge was limited, and there was little I could do to ease her suffering; but what I lacked in experience, I made up for in persistent dedication to help this person in need. Unfortunately, medical intervention could not relieve the natural progression of childbirth; Brenda needed comfort and companionship. Holding her hand and rubbing her back, I stayed with her and assured her that she was not alone. This moment stuck with me, as I learned that true patient care supersedes clinical procedures. I had an opportunity to provide comfort, a calm presence in the overwhelm of pain and fear, and support in a vulnerable and painful situation. This lesson shaped my experience in Mombasa, Kenya. From the bustling clinics where we treated hundreds of patients to the quiet moments of reflection in between, I realized that true healing requires more than just medical knowledge. It requires empathy, connection, and a deep understanding of the cultural and emotional contexts that shape people’s lives. Prior to this trip, I was accustomed to sterile, orderly spaces with private rooms, abundant supplies, and high-tech equipment. However, the atmosphere at Coast General Teaching and Referral Hospital is starkly different. The hospital is constantly overcrowded—corridors are packed with patients, loved ones asleep on the concrete outside, doctors rushing from bed to bed, and students following closely and silently. Private spaces are nonexistent. Gloves and masks, taken for granted in many other healthcare settings, are used sparingly. The lack of clean drinking water limits the ability to attend to patients’ most basic necessities. While the sight of lizards crawling on the walls and cats roaming freely through the hospital was initially jarring, this was a daily reality. Unwelcome bugs invade sterile spaces, intensifying an ongoing battle against infection. My experience at Coast General exposed not only the logistical difficulties but also the emotional and psychological toll on both patients and healthcare workers. The lack of privacy, the constant threat of infection, and the visible signs of resource scarcity paint a vivid picture of the harsh, demanding realities faced in these settings. Despite the less-than-ideal conditions, everyone in the hospital united, responding with resilience and resourcefulness. Where resources are lacking, the human spirit fills the void, and people overcome the limitations of medicine with the art of human connection. During one overnight shift in the maternity ward, a nurse asked me to grab a condom from one of the free bins in the hospital. Confused and sleep-deprived, I delivered the condom to a surgeon repairing a woman’s uterine hemorrhage. The patient had pushed through labor prematurely and was rushed to emergency surgery. Without a traditional uterine balloon tamponade (UBT), the surgeon responded creatively and efficiently. I watched as the doctor quickly created a makeshift UBT, inserting a catheter into a condom. She filled it with saline to apply pressure and stop the uterine hemorrhage. Despite unexpected challenges and limited resources, her resilience and inventiveness saved a young woman’s life. The staff are innovative and resourceful, constantly finding new ways to provide care in the face of adversity. I noticed cut-up cardboard boxes folded into makeshift file cabinets, just one example of the resourcefulness of the Kenyan people. These observations stand in direct contrast to the extreme wastefulness I have witnessed in the United States, where resources are disposable and easily replenished. The resilience and ingenuity of these healthcare professionals deepened my respect for everyone working in low-resource environments. In less optimal operative conditions, doctors and nurses maintain a delicate balance between rationing resources and prioritizing sterility in the hospital. This experience rejuvenated me during a long night shift and opened my tired eyes to the importance of flexibility, quick thinking, and problem-solving in medicine. It underscored the urgency of patient care, demonstrating how nurses and doctors sacrifice their time to address individual needs. Their consistent composure and compassion, in such trying conditions, inspired me. I left Mombasa with a newfound appreciation for the luxury of abundant resources and a sterile environment but, more importantly, with profound gratitude for models of resilience, adaptability, and unwavering commitment to healthcare. As part of the public health services sector, Coast General serves as an interventive facility, “providing the most accessible and affordable care for populations in Kenya” (The Current State of Healthcare in Kenya, 2024). The majority of the population cannot afford private hospitals or preventative care, so they go to this hospital exclusively for interventions. Anyone can be seen if they pay the minimal registration fee of only $5, as all additional expenses are handled after the patient is cared for. This method of care is drastically different from hospitals in the U.S., in which most medical consultations include a discussion about insurance policies or expenses. While Coast General remains one of the most accessible hospitals, there is an overwhelming ratio of patients to staff and an uneven distribution of resources compared to private settings. Unfortunately, “lower standards of care when compared to the private sector result in poorer patient outcomes and higher incidences of hospital-acquired infections” (The Current State of Healthcare in Kenya, 2024). This high risk of infection threatens all patients and healthcare providers. With no private rooms, individuals are disproportionately exposed to communicable diseases, and the open layout of the hospital exposes patients to animals or toxins from the outside. Because patients typically visit Coast General for intervention rather than routine health maintenance, they are at risk for long-term health complications. By the time they seek medical attention, their conditions have often progressed to severe stages, resulting in higher mortality rates and requiring more complicated treatments. This pattern highlights a critical gap in the healthcare system: the lack of preventative care. Without regular health checkups and screenings, the risk of acquiring non-communicable diseases (NCDs) significantly increases as well. Conditions such as “cardiovascular diseases, cancers, diabetes, and chronic obstructive pulmonary diseases are especially prevalent” (Disease Burden in Kenya, 2024). Unsurprisingly, these “NCDs account for 27% of the total deaths and over 50% of hospital admissions in Kenya” (Kenya NCD Report, 2015). As a result, the hospital is often a last resort, and many patients arrive when their illnesses are life-threatening, overwhelming an already under-resourced system. To mitigate this national issue, International Medical Aid hosts clinics, organizing multiple stations to simulate a comprehensive medical visit. During one of these clinics, hundreds of locals arrived to receive general testing, including BMI, blood glucose, and blood pressure. Afterward, they received individual consultations with local doctors and acquired appropriate medications from the pharmacy. This health clinic was incredibly moving—the overwhelming turnout of families, spanning multiple generations, reminded me how important these resources are in the local community. Moreover, the health outcomes I observed were concerning. I encountered patients with glucose levels as high as 28 mmol/L and blood pressure readings reaching 220/130, underscoring the dire consequences of insufficient preventative care. In a better-resourced healthcare system, these issues could have been identified and managed earlier, reducing the need for emergency interventions and improving overall outcomes. Preventative care is essential to mitigating long-term health risks, yet it remains inaccessible to the majority of the Kenyan population due to resource limitations and the overwhelming demand for emergency care. Therefore, lack of support for preventative healthcare not only burdens the public sector of the healthcare system but also contributes to the cycle of poor health outcomes. It is critical to bridge this gap by promoting regular health maintenance and providing adequate resources for prevention to improve the population's health and ease the strain on hospitals like Coast General. In addition to the public and private sectors, faith-based organizations (FBOs), supported by religious groups, contribute significantly to Kenya’s healthcare system. In fact, “30% of healthcare in Kenya is provided by The Christian Health Association of Kenya (CHAK) and the Kenya Conference of Catholic Bishops,” reflecting the widespread impact of spirituality on Kenyan culture (The Current State of Healthcare in Kenya, 2024). With smaller patient populations and a dual focus on prevention and treatment, FBOs incorporate religious teachings, offering both physical and emotional healing. While the public health sector and faith-based organizations are distinct in development, structure, and focus, faith and spirituality still significantly impact public healthcare. Healthcare workers and patients alike turn to religious practices or prayer in moments of need. Thus, faith transcends the boundaries that separate sectors of the healthcare system, connecting all providers under a universal goal of relieving pain and supporting the broader Kenyan community. In this strongly religious city, Coast General bridges the gap between medical intervention and cultural values. The hospital illustrates how, even in secular settings, faith is a consistent force for both patients and providers. Throughout my time, I observed religious influences on healthcare initiatives, inspiring unity and resilience and underscoring the necessity of culturally sensitive care. In the Women’s Health Clinic, for instance, we discussed menstrual hygiene and the female reproductive system. Many young women were shocked and visibly uncomfortable when we demonstrated the function of tampons because their religious beliefs rebuke inserting anything into the vagina before marriage. Additionally, tampons are foreign and unfamiliar to this population, so it is reasonable that the women responded with such hesitation. As a result, we shifted our presentation, approaching the topic of tampons and sexual intercourse with greater sensitivity and understanding. We created a safe space for vulnerable conversations, where the women could ask questions not only about menstrual hygiene but also about their bodies, relationships, and beliefs. This clinic revealed the importance of cultural awareness, taught us how to lead a discussion with transparency and respect, and reinforced the value of acknowledging religious foundations while still providing critical health information. Just as religious and cultural beliefs influence the way women approach menstrual health, these values impact more life-threatening conditions, such as Human Immunodeficiency Virus (HIV). While speaking with the young women about menstrual resources, we avoided conversations about contraceptives and intercourse. This education gap shocked me, especially when I recalled my own sexual health education, which included conversations about intercourse and emphasized the importance of contraceptives. In Kenya, where the HIV burden is severe, this lack of comprehensive sexual education was alarming. In Mombasa specifically, HIV prevalence is “1.2 times higher than the national rate, standing at 7.5%,” and young women face a disproportionately higher risk (Kenya HIV Estimates, 2015). Due to religious and cultural pressures, young adults rarely receive education on safe sex practices. This lack of awareness fosters guilt and anxiety, perpetuating a cycle of fear and social stigmatization surrounding HIV. Deeply rooted in religious beliefs, the stigma further exacerbates the HIV epidemic, as individuals struggle to reconcile their faith with the reality of their health needs. Without education that challenges these harmful stigmas, the crisis continues to grow unchecked. In one particularly heartbreaking case, a mother brought her one-year-old child to the emergency room. The boy presented with severe malnutrition and suffered from gastritis, pneumonia, and oral thrush—symptoms indicative of late-stage Acquired Immunodeficiency Syndrome (AIDS). Dr. Priyanka, the consultant, gently inquired whether the mother was on HIV treatment. The young mother averted her gaze and remained silent, ashamed to admit her status. With downcast eyes, she acknowledged that she birthed her son naturally and had been breastfeeding him, unknowingly increasing his risk of contracting the virus. As we learned from Dr. Shazim, there is a 10% risk of contracting HIV in utero, a 10% risk from the birth canal, and an additional 10% risk from breastfeeding (Dr. Shazim, 2024). Despite her child’s deteriorating condition, her silence made it difficult for the medical team to intervene appropriately. This case was not unique—many patients are burdened by the social stigma surrounding HIV, so they avoid acknowledging their diagnosis out of fear of rejection by their community or family. The intersection of faith and healthcare further complicates this issue, as some patients delay or refuse life-saving treatment due to deeply ingrained beliefs. Alternatively, we learned that some patients visit faith-based organizations as a substitute for modern medication. With a virus such as HIV, however, hypnotherapeutic or purely spiritual remedies are ineffective and leave the patient with a false sense of a cure (The Current State of Healthcare in Kenya, 2024). Navigating these challenges requires a delicate balance of empathy and respect. Although it was painful to witness patients deny themselves treatment, I learned to honor their values while striving to provide compassionate and culturally sensitive care. While faith can, at times, pose an obstacle to treatment, it also serves as a source of strength for patients and healthcare workers. In one instance, I assisted a nurse in the pediatric emergency unit with a young baby who urgently needed an IV placed. The boy was poked and prodded—nearly 30 times—each attempt unsuccessful. The mother remained calm while holding her screaming, squirming child, her quiet resolve contrasted with the growing tension in the room. My heart raced, while one nurse switched out for another, hopeful that a new set of hands might do the trick. Thirty minutes passed—still no luck. Focused, yet frustrated, the nurse looked at me and whispered, “I’m not sure who or what you believe in, but start praying.” Gently resting my hand on the baby’s head, I closed my eyes and prayed silently for a miracle. Moving from the child’s small feet to his jugular vein and finally to a scalp vein, we made one last attempt. Moments later, the IV was successfully in place. A palpable sense of relief washed over the room. The moment resonated with me, strengthening my conviction in the healing power of faith, especially during the most difficult days in the hospital. This experience underscored the profound intersection of faith and medicine—two forces that, in times of great stress, collaborate to provide comfort and hope. As a student, I felt powerless and underprepared, with little to offer beyond emotional support and a calm presence. However, these experiences with faith taught me a vital lesson about the true responsibility of a medical provider—not just to heal, but to support, aid, and comfort. Although faith and healthcare are intricately linked in Kenya, the strength of these cultural values extends far beyond the hospital walls. Immediately upon arriving, I recognized the interconnectedness that weaves the entire community. Peering out the bus window, I frequently saw locals smile and wave with curiosity and a general sense of welcome. They do not lead with judgment or criticism, but rather with a desire to understand and love. I will never forget a conversation I had with two nurses in the surgical ICU. At around 2 a.m. during an overnight shift, the hospital slept. I sat with a patient in the ICU who had Tetralogy of Fallot (TOF). He was recovering from open-heart surgery three days prior. That night, I was given a unique gift: an opportunity to share my perspective on a highly controversial topic. The nurses wanted to know me; they took an interest in my belief system. We did not argue over our differing opinions; instead, we laughed as we shared opposing viewpoints. In this unique interaction, we bonded over our differences. I appreciate those two nurses for their open curiosity and transparency. They are exemplary of the accepting and inquisitive Kenyan community, and I will carry this open-mindedness with me in my future career. At Coast General, an individual’s health is a collective responsibility. Relationships are at the heart of daily life, and the sense of community is as important to survival as any medical intervention. This communal mindset stands in contrast to the more individualistic, fast-paced culture I am accustomed to. I feel a profound sense of gratitude for the opportunity to meet such selfless, caring individuals. The Mombasa community made me feel welcome and appreciated, from the kind smiles of the IMA staff to the warm hugs from children at the hygiene clinics. Overall, this trip reminded me that friendship and community are invaluable in every area of my life. I witnessed this firsthand when we visited the Maasai community, where the community is the foundation of survival and success. The Maasai live by an unspoken code of selflessness, each member playing a vital role in upholding the tribe’s wellbeing. Watching them work together was awe-inspiring. One of the most striking moments was witnessing the Maasai men come together to build a fire—a process that requires collaboration, patience, and teamwork. The same spirit of unity is carried through every aspect of their lives, from the boys who hunt a wild lion as a rite of passage to the interactive dance ceremonies that welcome guests into their community. The men protect the land and lead their families, building homes that, after nine months of labor, remain for nearly a decade. The women are quiet yet resilient. They nurture their children, prepare meals for the family, and craft intricate handmade jewelry. The cattle, sheltered in the heart of the village, provide milk and resources in return for protection. Even the dogs have a critical function in guarding the community. The Maasai convey how survival is most successful when the tribe works as one—when each individual commits to the shared goal of protecting and sustaining their people. This sense of community mirrored the relationships I built in Mombasa. Whether during night shifts in the hospital, long debriefs after an intense day, or quiet moments on early-morning bus rides, my peers met me with patience and grace. Just like the Maasai community, we formed a tight-knit family of interns, doctors, and nurses—each of us supporting one another through the chaotic and often overwhelming demands of the hospital. International Medical Aid fosters this supportive and positive community. The interns and staff cultivate a collaborative and culturally immersive environment. This program aims to inspire prospective healthcare workers, encouraging self-awareness and reflection. The weekly clinics, lectures, and group discussions are a testament to IMA’s effort to promote compassion, respect, and humility. I am incredibly grateful for the opportunity to work alongside such dedicated and selfless individuals. The bonds we formed, built upon shared values of loyalty and a genuine passion for healthcare, reminded me that medicine is not a solitary pursuit. It requires a collective effort—a team of individuals willing to sacrifice their comfort for the betterment of the patient and the entire community. This experience reaffirmed that the healthcare community is a tribe, driven by a deep responsibility to those we serve. As I continue my journey toward becoming a doctor, I carry the lessons learned from the Maasai community, the greater Kenyan community, and the relationships I formed with my fellow interns and future healthcare professionals. I plan to apply these tools and continue my path to medicine with awareness and intentionality, because individual success depends on our ability to work together and remain loyal to our patients, to each other, and to the shared goal of healing.

The program has not only deepened my passion for healthcare, but also opened my eyes to global healthcare disparities, the beauty of community outreach, and the vital role that systemic infrastructure plays in delivering healthcare. In the hospital, I shadowed a range of specialties, giving me the opportunity to watch live births and learn pathology alongside medical students. Our outreach clinics had lasting effects on the community, and we were able to see this in real time. Even after educating and answering questions on menstruation and women’s health for 1.5 hours, girls continued to come up to me with questions on the way to the bus. You could see the relief on children’s faces when they learned about issues involving menstruation or mental health and realized they weren’t alone. Children who had previously attended the hygiene clinic remembered the information and were able to assist in educating their peers. One of the issues Kenya suffers from is poor health literacy. Through these clinics, we were not only able to provide supplies for immediate care but also make a lasting impact through health education. As demonstrated in the hygiene clinic, even educating just one group of students can make a difference as they continue to educate each other. From the second I arrived in Kenya, the IMA staff made it feel like home. I felt safe at all times, and if I ever needed anything, our program mentors were easily accessible. The accommodations were more than comfortable—the food was amazing, and the house and kitchen staff always went out of their way to ensure we were taken care of. I often took naps after a long shift at the hospital, causing me to miss the planned dinner time. However, Joshua always made sure there was a meal left for me to wake up to. Being the only new person to the program during my time in Kenya, I was nervous to go on the safari alone. Thankfully, Vivian was there to accompany me the whole time, and there was no one better I could have asked for. She immediately put me at ease and became a lasting friend in the process. I did not expect to love Kenya as much as I did, and I truly believe the IMA staff played a significant role in that. I will always be grateful for my experience there and hope to come back soon.

International Medical Aid did a fantastic job of making sure all of the interns were well taken care of. There was never a time when I needed something and IMA was not immediately working to fix the issue. The IMA team in East Africa was so accommodating, welcoming, and overall kind to all of the interns. They genuinely wanted to get to know each and every intern in order to make your experience the best it could possibly be. Personally, I became really close with the transportation team and the kitchen staff whilst in Mombasa. These individuals made my day every time I got the opportunity to talk to them and get to know them. The kitchen staff made amazing food from all different cultures to accommodate everyone's different tastes. I was able to taste classic Kenyan dishes as well as my favorites from home, like pancakes in the morning at breakfast. If you have an allergy or dietary restriction, the kitchen staff will not rest until your dietary needs are not only met but exceeded. They would go above and beyond at every meal, making the whole experience better for everyone as we were all well-fed. As for the transportation team, my favorite thing to do was sit in the passenger seat of the bus on the way to/from the hospital or community outreach and chat with the drivers. I was able to get to know the transportation team on a more personal level, making the drives more fun when you had someone you considered a friend driving rather than just an employee. As for the in-country support, the staff of IMA did a great job of communicating with us quickly when we had a question. They were also clear with us on what was going on around Mombasa that we as interns should be aware of (politically, socially, and culturally) as we made our way throughout the city. As for the living accommodations, the residence was nicer than I could have ever imagined. From the pool the interns would frequently hang out in at night, to the spacious living quarters, the residence gave us more than enough room to play games at night, live amongst 50+ other people comfortably, and rest and relax after a long day. The residence was sparkling clean with comfortable accommodations and, again, the best staff taking care of the living spaces and grounds. Given that the residence was located in a gated community in one of the nicest neighborhoods in Mombasa, I always felt safe and at home. Whenever we would leave the residence, I still felt extremely safe and cared for by the staff members and my fellow interns. However, Mombasa as a whole is made up of some of the nicest, most welcoming people who almost never make you feel as though you are in an unsafe situation. All in all, I would rate this experience a 10/10. I was on the phone with my dad the night before I left, begging to push back my flight just a few more hours to spend more time with all of the amazing interns and staff I met during my six weeks in Mombasa. I did not want to go home, and I still miss it every day. In my opinion, Mombasa changed me for the better, not only as a healthcare professional but also as a person. As a nursing intern going into my senior year of nursing school, I was able to help out the nurses and doctors in the hospitals. Whether I was providing the patient with a hand to hold during a procedure, or doing head-to-toe assessments and giving authorized medications to help relieve the nurses of their heavy workload, I was able to see the impact on not only myself but also the community through the things I did. Mombasa changed me as a future nurse, teaching me how to problem solve in situations where resources and staffing are at the absolute minimum. In the future, I will be able to think quicker on my feet and problem solve in my workplace thanks to my time in Kenya. I was also able to see my impact on the community of Kenya through community outreach set up by IMA and through my patients getting better in the hospital. Whether I was watching a malnourished patient get better over my weeks in the hospital or teaching a child at the local school how to brush their teeth, I was seeing the impact not only myself, but the entire organization of IMA had on the community around us. This program is very special, and anyone who has the opportunity to participate should consider themselves very lucky. Thank you, International Medical Aid. Kwaheri, Kenya! It has been about a year exactly since I called my parents to tell them my wishes of spending my summer in Africa as a nursing intern. Although they were on board with me going abroad to experience other healthcare systems and help those in need, they were not sold on the idea of me flying by myself for the first time to a continent so far away from home. With my fantastic marketing skills, I was able to convince them that I would, in fact, be killing three birds with one stone by going on this adventure. I would gain vital clinical hours to set me apart for nursing job interviews coming up sooner than I would like to admit; I would get the opportunity to study abroad in a sense which I would not have otherwise been able to do due to the constraints of the nursing school timeline; I would get to go to the continent I had always dreamed of traveling to, Africa. Fast forward about ten months later, and I was on a plane en route to Mombasa, Kenya, where I did not have a single clue what I was about to experience over the course of the next six weeks of my life. Upon my arrival to Mombasa, I had an instant culture shock. For starters, Kenyans drive like crazy in comparison to Texas drivers—and that is saying something—and all of the people are very friendly and welcoming, which is uncommon in the United States, even in the South. Thankfully, International Medical Aid did a wonderful job of properly introducing not only Mombasa, but also the country of Kenya to all of the interns within less than 24 hours of their arrival. We learned about the political, social, and religious cultures of both Kenya and Mombasa specifically. We were also given a “Swahili survival guide” of sorts to jumpstart the interns’ typically rocky journey of learning the language. These first few lectures and tours of the city helped put into perspective where our planes had touched down just the day prior, immersing us into the culture and welcoming us into a place like no other. Upon applying to IMA, I expected to learn and grow as a nurse and as an individual. What I did not expect was how much I really would learn during my six weeks with IMA. Throughout my time at Coast General Teaching and Referral Hospital in Mombasa, Kenya, I was able to experience nursing in a multitude of different specialties. Naturally, each specialty came with its own challenges and learning curves. Through encountering these obstacles head-on in each unit, I was able to come back to the United States as a much more well-rounded nurse. My rotations made me think quickly on my feet and problem solve as I went, namely my rotations in the OB-GYN, Pediatrics, and A&E units. During my OB-GYN rotation, I encountered mistreatment of patients. Throughout my rotation, I saw healthcare professionals slapping patients and pinching their lips shut if they made noise while in labor. I saw patients ignored when they voiced their pains and fears as they progressed through labor. I saw a lack of patient consent for procedures such as episiotomies. Witnessing these events taught me how, as a nurse, I must step up to enforce patient-centered care and advocate for my patients to receive the best possible treatment, even when the unit is short-staffed and running low on resources. I did this by taking initiative in the care of the patients—providing them with non-pharmacological pain management methods I had learned and used during my OB-GYN rotation in the United States. These measures included massage, changing the patient’s position, and lending a hand to hold in order to calm their nerves. While on the OB-GYN unit, I learned not only how to take initiative in uncomfortable situations for the good of my patients, but I was also able to show staff members how comfort measures can help enhance a patient’s entire birthing experience. Pediatrics taught me the importance of time management as a nurse. During this rotation, I had the pleasure of shadowing and assisting Nurse Wafa in the pediatric inpatient ward. During my time there, the ward was full, and we had approximately forty patients needing medication administration. Given that there was only me, Wafa, and a nursing student available to help all forty patients, it was very difficult to make sure all medications were given to every patient on time. Therefore, we created a system where the nursing student would chart, Wafa would draw up the medications, and I would administer all medications I was approved to administer as a student nurse. In working with Wafa and the other student nurse from Kenya, I was able to learn about time management while still providing my patients with safe, timely medication administration. Arguably, my rotation in the Accident and Emergency Department at CGTRH taught me the most out of all my rotations. Whilst in the A&E, I learned how to think quickly on my feet to help solve unforeseeable problems as they arose with the ever-changing patient conditions present in this unit. I learned how to jump in where needed to assist doctors and nurses in doing assessments and vitals, as well as IV insertions, as I had previously been trained and approved to do such things. This was a huge help to the staff, as there were also things I could not do, such as comforting family members who had just lost a loved one, administering blood, or giving high-risk medications, to name a few. That being said, I was able to learn so much with the guidance of the staff in the Accident and Emergency Department as they gave me opportunities to learn new things, practice my skills, and ask questions when appropriate. For example, the physicians would point me toward a patient to assess and ask me to guess their presenting diagnosis. By doing this and reporting back with my notes, I was able to receive instant feedback and advice on my assessments. My learning did not end in the hospital. Much of it took place outside the clinical setting in the form of cultural and global health discussions. Through IMA-led lectures and conversations with fellow interns, I was able to better understand how different healthcare systems operate based on each country’s laws, cultural beliefs, and available resources. With interns from around the world, I learned how the U.S. healthcare system differs from those in Australia, Dubai, the UK, Kenya, and more. Thanks to International Medical Aid, I have begun to pay closer attention to healthcare differences worldwide so I can become a more globally aware nurse for my patients. By understanding how a healthcare system works, it becomes easier to recognize inequities in hospital infrastructure and patient care across countries. One of the major differences I noticed between Kenya and the United States was how few patients were insured in Kenya. Even at what U.S. citizens would consider the low price of five dollars a month for insurance, “the insurance scheme is still unaffordable to a majority of Kenyans” (IMA, 2024). This means that many Kenyans are paying out of pocket for healthcare services, making care less accessible and affordable for a vast portion of the working population. Throughout my time in CGTRH, I saw hardships and challenges in every unit I encountered. Many of these issues stem from socioeconomic disparities among different populations across Kenya. In 2020, BMC Health Services Research conducted a quantitative study on the “cost-related unmet need for healthcare services in Kenya” (Arsenijevic et al., 2020). The study found that multiple factors drive unmet healthcare needs due to cost, requiring a multifaceted approach to address inequities, especially among the most vulnerable and marginalized populations. In short, lack of health insurance, limited access to services, and socioeconomic disparities all contribute to patients’ challenges in acquiring necessary healthcare. Throughout my rotations at Coast General, I saw the effects of these factors firsthand. One patient in particular came in with extreme malnutrition during my night shift in the Pediatric A&E during my third week in Mombasa. A couple of weeks later, during my Pediatric rotation, I saw the same child looking much healthier and in better spirits, ready for discharge. When I came back in my last week with IMA to say goodbye to my favorite nurse in Pediatrics, I saw that my patient had been moved to a “waiting” area where children and their mothers stay until they can pay off their medical bills. Their bill continued to increase each day they remained in the hospital, as they were still using bed space and resources. When I asked the mother what was happening, she said they were 30,000 Kenyan shillings short. This mother and son were still there when my internship ended, and I will never know if they were able to go home. This is a real-life example of cost-related barriers affecting real patients. Each day during my rotations presented different challenges and complications. I learned that many of these issues were linked to the political approach taken toward healthcare in Kenya. I witnessed the effects of government shortcomings firsthand, particularly regarding healthcare worker pay and support. During my time in Mombasa, I observed the country struggle under growing tension over how citizens and healthcare workers were being treated. The Kenya Medical Practitioners, Pharmacists, and Dentists Union (KMPDU) “has accused county governments of failing to prioritize healthcare workers’ welfare, with some counties owing salaries for up to five months” (Aura, 2024). Due to strikes by healthcare professionals, staffing became even more limited, making it harder for hospitals to meet patient needs. This even affected interns in the IMA program, as there was a week when no surgeries were available to observe in the Surgical Ward. These issues between the Kenyan government and the healthcare system are deep-rooted and affect many more people than those whose voices are heard. Unfortunately, it is primarily the patients who are put in danger by not receiving proper or timely treatment due to these systemic inequalities. Throughout my time at CGTRH, I learned how these political and structural challenges shape patient care. I learned so much from my six-week adventure in Kenya. Whether I was in the hospital, doing community outreach, or just sitting in the living room with my fellow interns, I was constantly learning—professionally and personally. Professionally, I worked alongside some of the smartest people I have ever met from all over the world, collaborated across specialties, and witnessed a completely different way of practicing medicine due to limited resources and staffing. I also saw stark inequalities and recognized many things we take for granted in the U.S. Personally, I met some of the kindest individuals I have ever known, was welcomed into one of the most vibrant cultures I’ve encountered, and reignited my love for adventure. Thanks to International Medical Aid, I experienced the greatest period of personal and professional growth of my life so far, and for that, I will forever be grateful.